Challenging society on behaviour

Recent stories about the treatment of people with what’s often referred to as “challenging behaviour” have given the experts pause for thought about society’s attitudes towards such people and such behaviour. Ian Macrae discusses some of the issues with Professor Peter Beresford of Brunel University.

Central to Peter Beresford’s views on the way in which people with challenging behaviour are treated or mistreated is his belief that there is no excuse for getting it wrong.

Beresford believes that a sufficient body of knowledge and expertise has built up over recent decades that should give those involved in social care and education the wherewithal to handle situations better.

In particular he cites the work of the late Jim Mansell.

“At the time of Winterbourne View he wrote a piece that restated what really is the knowledge that people in his field have generated over the last 20 years.

“Apart from the fact that ‘Challenging behaviour’ is quite contentious because it individualises what is really a social issue, what was being done at Winter­bourne View was the absolute antithesis of what we have known for years is needed for people identified as having challenging behaviour.

“If people are behaving in difficult ways or can be prompted by circumstances to do so, then the way you move on and address that and make progress is through developing relationships with those people.”

It’s unsurprising that this long-time campaigner against institutionalisation and for human and individual rights regards segregation of such people as inappropriate, not least because it is those very institutions that can provide precisely the triggers for that sort of behaviour.

They are also likely to be just the sorts of institutions that are least well equipped or prepared to deal with difficult behaviour.

“Where there are people who may have had those kinds of experiences that result in that kind of behaviour, and who’ve been damaged or hurt in such ways, there are so many issues. There’s the building of trust; there’s the building of confidence in relation to particular people; there are issues of communication. And none of that is forthcoming without the starting point of recognising the primacy and importance of a relationship with an appropriate and supportive worker.”

Therapeutic approaches such as this are often dismissed theoretically or not adopted or practised practically because people argue that they are too intensive in terms of resources. Professor Beresford does not agree.

“I bet it’s less expensive than running somewhere like Winterbourne View”, he says.

“I recently had a conversation with someone who works in this field and he said that an input as soon as possible, by a person who’s got those sorts of qualities and skills, could begin to make a massive difference quite quickly. You’d obviously need to start with the person needing a chance to get to know someone and feel safe with them, but input could be tapered and still make an unbelievable difference.”

Asked why society’s and the system’s default response to dealing with challenging behaviour favours restraint, whether it’s physical, chemical or psychological through exclusion, Professor Beresford says that there are institutional relics that live on as vestiges of former practice which then shape the treatment that’s given today.

“It’s the difference between an essentially medical model of learning difficulties and the community-based more social approaches that I suspect might lie at the heart of it. People from a medical background some­times think in terms of what will work in a particular kind of place, and think of treatment and particularly of chemical treatment. Those are the things you rely on.”

Beresford argues that by delegating responsibility for dealing with challenging behaviour, society is making two big mistakes. First, it’s shirking its own responsibility towards accepting such people and such behaviour. Second, it’s giving that responsibility to the very people and institutions who may have entirely the wrong cultural approach to dealing with such things.

“The reality is that those of us who aren’t used to being with people with learning difficulties, who may not communicate conventionally, and who may be associated with difficult behaviour – and that can mean frightening or violent behaviour – may not be in the best of states to respond in an appropriate way.

“The fact that people in these situations can be segregated is important because segregated places are places which generate their own cultures, their own rules and of course, their own possibilities of abuse.

“But let’s get real about this. We’ve now had decades of expert work which should mean we don’t have to respond out of ignorance and total isolation. We do have a body of knowledge and expertise to know how we can deal with these things.”

All of this, Beresford argues, says much about society’s continuing attitudes to and view of people who’re different or disabled.

“I don’t think those values come from the bottom up. I fear that those values are imposed from the top down. And if ever there’s been something that symbolises that, it’s the way in which the Government, the politicians and the media have recently been colluding on the most awful kinds of assertions and statements about disabled people in respect of welfare reform.

“This is about fear of the unknown and we live in a world that encourages that by keeping us apart.”

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